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Arterial steroid injection therapy can inhibit the progression of severe acute hepatic failure toward fulminant liver failure

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World Journal of Gastroenterology 2006年第41期12卷 6678-6682页

作者： Kazuhiro Kotoh Munechika Enjoji Makoto Nakamuta Tsuyoshi Yoshimoto Motoyuki Kohjima Shusuke Morizono Shinsaku Yamashita Yuki Horikawa Kengo Yoshimitsu Tsuyoshi Tajima Yoshiki Asayama Kousei Ishigami Masakazu Hirakawa Department of Medicine and Bioregulatory Science Graduate School of Medical Science Kyushu University3-1-1 MaidashiHigashi-kuFukuoka 812-8582Japan Department of Clinical Radiology Graduate School of Medical ScienceKyushu University3-1-1 MaidashiHigashi-kuFukuoka 812-8582Japan

AIM: To utilize transcatheter arterial steroid injection therapy (TASIT) via the hepatic artery to reduce hepatic macrophage activity in patients with severe acute hepatic ***: Thirty-four patients with severe acute hepatic failure were admitted to our hospital between June 2002 to June 2006 providing for the possibility of liver transplantation (LT). Seventeen patients were treated using traditional liver supportive procedures, and the other 17 patients additionally underwent TASIT with 1000 mg methylprednisolone per day for 3 continuous days. RESULTS: Of the 17 patients who received TASIT, 13 were cured without any complications, 2 died, and 2 underwent LT. Of the 17 patients who did not receive TASIT, 4 were self-limiting, 7 died, and 6 underwent LT. Univariate logistic analysis revealed that ascites, serum albumin, prothrombin time, platelet count, and TASIT were significant variables for predicating the prognosis. Multivariate logistic regression analysis using stepwise variable selection showed that prothrombin time, platelet count, and TASIT were independent predictive factors. CONCLUSION: TASIT might effectively prevent the progression of severe acute hepatic failure to a fatal stage of fulminant liver failure.

关键词： Methylprednisolone Fulminant liver failure Macrophage Acute hepatic failure multiple logistic analysis

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